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WHO decided where are EMT's go? We have a limited number of rescue squads, and even more limited Emergency Care units. IF they get a call for an overdose, and a family man down in his front yard possibly having a heart attack who decides who gets the last ambulance available?? Will they divert an rescue squad on the way to an OD when a call like mentioned above comes in?? How about a family in a car accident?? Husband, wife and kids in need of emergency care??

With the volunteer system in SoMD as a backup, we rarely run out of ambulances. In places like DC where ambulances are a constrained resource, we already have cardiac patients dying while paramedic units are tied up with addicts and their choices.

How do you determine the difference between an overdose that's going to kill them, and a high that you're getting ready to ruin?

I see all the facebook posts about parents overdosing.. or somebody behind the wheel overdosing.. but they don't look like they are overdosing to me.. they just look passed out and waiting for their high to pass before they do it again.

Serious question, how do you tell the difference? If they are breathing and their heart is still beating do you still give them Narcan??

WHO decided where are EMT's go? We have a limited number of rescue squads, and even more limited Emergency Care units. IF they get a call for an overdose, and a family man down in his front yard possibly having a heart attack who decides who gets the last ambulance available?? Will they divert an rescue squad on the way to an OD when a call like mentioned above comes in?? How about a family in a car accident?? Husband, wife and kids in need of emergency care??

-Serious question, how do you tell the difference? If they are breathing and their heart is still beating do you still give them Narcan??
Narcan is used to reduce the effect of the opiate on the patients respiratory system. If they are breathing adequately, and have no signs of inadequate perfusion < blue lips for example > then Narcan may not be given.
-WHO decided where are EMT's go? We have a limited number of rescue squads, and even more limited Emergency Care units. IF they get a call for an overdose, and a family man down in his front yard possibly having a heart attack who decides who gets the last ambulance available?? Will they divert an rescue squad on the way to an OD when a call like mentioned above comes in?? How about a family in a car accident?? Husband, wife and kids in need of emergency care??
EMS are dispatched by the Emergency Operation Center in Leonardtown. We < I'm a Paramedic > go where we are dispatched. If we are enroute to an OD call, and the call you mentioned goes out, we have the authority to re direct our unit to the call. Its all based on the situation. Is there a BLS < Basic Life Support > ambulance enroute to the scene ? They carry Narcan , are trained to recognize an opiate OD , and can administer it if the situation dictates < patient presentation > Is there another Paramedic onboard the ambulance as well as the BLS members? If so, they will have a complete ALS ( Advanced Life Support, Paramedics > kit on the ambulance. Again, the situation will dictate the EMS response < within reason >

If we required a valid prescription for the opioid the person ODd on before giving Narcan, it would reduce the number of doses by a factor of 20. Eventually, it would also reduce the number of ODs as many of the addicts would die off and the rest would get the message. However, I don't see to a legal or ethical way of implementing such a change.

I argue prescriptions of opioids is what is driving the heroin problem now.

Doesn't change the fact that wasting tax payer dollars to bring drug abusers back to life only to drain hard working people even more. If you don't see that then I would venture to say that you are a common sense hack.

They should then be able to refuse to pick up smokers having an emphasima/asthma attack. And of course don't pick up the fatties having diabetes or cardiovascular issues.

Maybe slip a bit further down this slope and don't pick up people who broke bones at sporting events. You chose to engage in physical contact, my tax dollars shouldn't provide you a free ride to the hospital.

They should then be able to refuse to pick up smokers having an emphasima/asthma attack. And of course don't pick up the fatties having diabetes or cardiovascular issues.

Maybe slip a bit further down this slope and don't pick up people who broke bones at sporting events. You chose to engage in physical contact, my tax dollars shouldn't provide you a free ride to the hospital.

Difference none of that is illegal.

If what I say offends you then you really don't want to hear what I keep to myself.

I argue prescriptions of opioids is what is driving the heroin problem now.

What's driving it is (a) the lack of mental health services, i.e. medical doctors and (b) cheap heroin. It's become the drug of choice for those with untreated mental health issues.
Not as cheap as alcohol, but cheaper than pills.

I think people should have an IQ/Ignorance card in their pocket, those with a certain score don't get emergency services. A lot of you would be left to die.

Overdoses are the everyday user, typically the overdose patient is one who has stopped using and falls off the wagon. Again, you might be happy to know, a group at highest risk is people just released from jail (that's where we send our drug addicts), because booze is a socially accepted way to destroy your life, we let alcoholics off the hook. Both diseases are treated in similar manner. Root cause of both are the same. Typically people with untreated depression and/or anxiety.

What's driving it is (a) the lack of mental health services, i.e. medical doctors and (b) cheap heroin. It's become the drug of choice for those with untreated mental health issues.
Not as cheap as alcohol, but cheaper than pills.

I think people should have an IQ/Ignorance card in their pocket, those with a certain score don't get emergency services. A lot of you would be left to die.

Overdoses are the everyday user, typically the overdose patient is one who has stopped using and falls off the wagon. Again, you might be happy to know, a group at highest risk is people just released from jail (that's where we send our drug addicts), because booze is a socially accepted way to destroy your life, we let alcoholics off the hook. Both diseases are treated in similar manner. Root cause of both are the same. Typically people with untreated depression and/or anxiety.

All very good points, and all true. I just disagree on the root cause.

I had to do a research paper last semester on heroin. That included what drove the increase in use. Many many things point to an over-prescription of opioid painkillers.

I argue prescriptions of opioids is what is driving the heroin problem now.

It is certainly what gets many addicts started on the opioid track. The actual OD is usual heroin or a heroin/fentanyl or heroin/carfentanyl mixture.
It is uncommon to see ODs from prescribed opioids in a non-addict who takes them for cancer or an acute injury.

It is certainly what gets many addicts started on the opioid track. The actual OD is usual heroin or a heroin/fentanyl or heroin/carfentanyl mixture.
It is uncommon to see ODs from prescribed opioids in a non-addict who takes them for cancer or an acute injury.

I agree, I've known people who were prescribed opiate pain killers and did not turn into a heroin addict. I think a lot of it has to do with personalities.